Dr. Beverley Deloris Wilson
Pediatrician
1615 Middleton Street
Orangeburg
, South Carolina 29118-4885
Dr. Beverley Deloris Wilson
Pediatrician
1615 Middleton Street
Orangeburg
, South Carolina 29118-4885
(803) 536-6000
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Beverley Deloris Wilson
- P.o. Box 2865 1615 Middleton Street
- Orangeburg, SC
- Zip : 29118-4885
- Phone : (803) 536-6000
Second Address
- Dr. Beverley Deloris Wilson
- 1615 Middleton Street
- Orangeburg, SC
- Zip : 29118-4885
- Phone : (803) 536-6000
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Is Dr. Beverley Deloris Wilson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 16075 | SC |
National Provider Identifier
| NPI | 1013079870 |
|---|---|
| Provider Name | Dr. Beverley Deloris Wilson |
| First Address | Orangeburg, SC 29118-4885 |
| Second Address | Orangeburg, SC 29118-4885 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/12/2006 |
| Last Update Date | 06/08/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 160756 | (05) | SC |
| F28541 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.